Pickleball Magazine 2-4 Courtesy of Pickleball Channel | Page 49

Osteoarthritis is a progressive degenerative disease
which typically worsens with age. However, some of the
risk factors that predispose an individual to osteoarthritis
include: genetics, obesity, joint trauma or injury, gender,
race and certain occupations and recreational activities.
For athletes participating in gravity based sports and
activities, the loading, impact and surrounding soft tissue
damage causes stress on the cartilage.
Arthritis is easily diagnosed by film x-rays or magnetic
resonance imaging (MRI). These typically show a loss of,
or irregular joint space with calcified or damaged cartilage
and osteophytes.
The greatest threat to the joint and structural system
of the aging athlete is not the aging process itself, but
inactivity. Motion and activity are critical to maintain
joint and articular cartilage health and healing. Once
osteoarthritis advances and the pain increases and
mobility decreases, the aging athlete is faced with either
giving up or modifying his sport or switching to a more
joint friendly activity, such as swimming or cycling.
In the past, treatment for degenerated joints consisted
of oral NSAIDS, cortisone injections and arthroscopic
surgery. However, some patients who use NSAIDS develop
serious gastrointestinal (GI) side effects, due to the acid
content in these medications. Alternative treatment
with a combination of glucosamine and chondroitin has
not proven to be an effective treatment. Bracing can,
however, sometimes be an effective non-surgical option
for instability in the knees and ankles.
New advances in medical treatment for degenerative
joint disease have given many athletes a new lease on
life. Currently, joint instability and cartilage wear can
be treated with prolotherapy, consisting of platelet rich
plasma therapy and stem cell injections. Another non-
surgical option is the injection of Hyaluronic acid. This is a
gel like substance made from chicken combs that cushion
and lubricate the joint and acts as a shock absorber. The
application of moist or dry heat can also help to decrease
pain, stiffness and increase mobility. When the pain and
inflammation is more acute, ice application also can be
helpful.
When non-surgical options have been exhausted and
the pain, inflammation and limitation of motion become
unbearable, joint replacement or arthroplasty becomes
an option. The choice for a total or partial arthroplasty
is based on numerous factors: age, activity level,
weight and the extent of degenerative disease. Partial
joint replacement has a higher failure rate than total
replacements. However, partial arthroplasty has fewer
complications, reduced time in the hospital, a smaller
incision with less blood loss and a quicker return to
normal activities.
Last year, I had the opportunity to play on a Decoturf
cushioned Pickleball court in Colorado. This surface played
like a normal hard court but provided cushioning similar
to playing on a soft tennis court. Unfortunately, the
Decoturf system is expensive and not readily available at
this time. Because these courts offer real relief for older
players with sore, worn out arthritic joints, hopefully the
trend toward cushioned courts will continue.  •
Alan Bragman is a chiropractor living in
Atlanta, Georgia. He is an IPTPA-certified
coach and a 4.5 level player. In addition, he is
a former Cat 3 cyclist, nationally ranked table
tennis player and inline speed skater. He was
on the medical advisory board at Bicycling
magazine for 10 years and has written for
numerous other sports publications.
JULY/AUGUST 2017 |
MAGAZINE
47